Liver Recipient Pushes for Organ Donation

Patient Parner Kim Escarcha

Liver Recipient Pushes for Organ Donation

Her positive attitude is contagious. Kim Alexis Escarcha has that beaming smile throughout any given day but what her smile might not tell you is that she was diagnosed with Biliary Atresia just weeks after she was born and that her family has always been worried about her condition.

Biliary Atresia is a disease of the liver and bile ducts that occurs in infants. Symptoms of the disease appear or develop between two to eight weeks after birth. The bile ducts are narrow, blocked or missing.

“I had my first surgery when I was seven weeks old. My family was told I may not live long to be five years old. I am now 20 by God’s grace. All my life, my family was cautious of my condition,” says Kim.

The surgery Kim is referring to is a Kasai procedure which is a temporary solution to Biliary Atresia. The operation helps in normalizing the functions of the bile ducts for months or in some cases, years.

“Except for the obvious bloated tummy and yellowish eyes and complexion, I tried my best to live a normal life.”

In Kim’s case, she had a normal childhood which meant going to school on a regular basis, less or no hospitalization at all, and a lot of fun times with family and friends. She enjoys hanging out with her siblings and friends and loves watching Korean drama and TV shows.

In fact, the last movie she saw was “Train to Busan,” a South Korean zombie apocalypse horror film. She watched it with her family last September 2016 to unwind and take pleasure in the simple joy of watching movies, instead of being miserable partly caused by the travails of looking for a liver donor.

It was in August 2015 when Kim’s diagnostic tests revealed that her liver function was fast deteriorating thus making liver transplant necessary and imminent.

Kim’s gastroenterologist, Dr. Eternity Labio, referred her to Dr. Vanessa De Villa for further evaluation and for the transplant procedure. Dr. De Villa is the head of the Center for Liver Disease Management and Transplantation (CLDMT) of The Medical City.  Kim started seeing Dr. De Villa at CLDMT in November 2015.

Her mom, Blesilda, knew that The Medical City has been doing successful liver transplantation procedures since 2011.But for her, there’s no harm in exploring other possibilities, like having Kim’s liver transplant in Taiwan.

“I remember my mom asked me to come with her to this gathering of Biliary Atresia babies who underwent liver transplant in Taiwan. At that time, we had  already met Dr. De Villa.”

“Then one day, my mom asked me if I wanted to have my transplant in Taiwan, I told her, no. She asked me why, then I said I wanted Dr. De Villa to do my transplant here in the Philippines because I believe in her. I trust her. I feel safe just knowing that she would do my transplant and that's when we decided that I would undergo the procedure at The Medical City,” relates Kim.

During the early part of 2016, Kim’s condition worsened. She had episodes of gastrointestinal bleeding due to portal hypertension and a few instances of disorientation which are scary signs of liver dysfunction or of a failing liver.She knew then that she badly needed a liver donor.Kim and her family endured the wait for the living liver donor which turned out to be difficult and frustrating.

The family identified possible liver donors but some problems came up along the way. One of the prospects was Kim’s aunt but after her evaluation as a donor, it was found out that she was not fit to donate part of her liver to Kim.

While finding a suitable living liver donor was a challenge, there was another option - deceased organ donation which involves transplanting a liver that has been removed from a person who has just become brain dead.

Kim was put on the deceased donor waiting list by the Philippine Network for Organ Sharing or PhilNOS in July 2016.

“God in His infinite grace and mercy provided a liver donor for me last October. What a day it was – a miraculous chance for a second life – mainly because a family decided to donate an organ of a deceased family member,” says Kim.

TMC’s liver transplant team, composed of highly qualified and internationally-trained experts led by Dr. De Villa, undertook the delicate surgery lasting nine hours and giving Escarcha a new lease on life. The team removed her diseased liver and transplanted a cadaver liver from a brain dead person. Kim underwent the surgery on October 20, 2016 and was discharged from the hospital two weeks after.

Kim is the 11^th liver transplant patient of TMC, and the fourth among the adults. Dr. De Villa says that Kim is very lucky to be allocated a liver graft from a deceased donor because there is a huge shortage of organs in the country.

"As soon as we accepted the offer of a liver for Kim, the arrangements for procurement were made, facilitated by our hospital transplant coordinator Dr. Rica San Diego in collaboration with the Human Organ Preservation Effort (HOPE) of the National Kidney and Transplant Institute, where the brain dead donor was. The TMC donor team went to procure the liver at the NKTI in mid afternoon."

"The team was back after three hours with the new liver for Kim. In the meantime the recipient team already started the operation to remove Kim’s cirrhotic liver which was soon replaced with the newly obtained liver graft," recounts Dr. De Villa.

She adds that there were no major problems after the transplant operation.

"With the help of other specialists in the multidisciplinary team, the postoperative course of Kim was smooth and she was able to go home in two weeks," adds Dr. De Villa.

“I am so far so good. My life is in God’s hands alone. God has given me the bigger thing – a new liver - He will do the rest for me according to His will and purpose,” says Kim.

Mother and daughter were relieved that they made the right decision.

“We are forever thankful to all those whom God used and will use during this entire journey, specifically, The Medical City's CLDMT led by Dr. De Villa and Dr. Rica San Diego, head of the Organ Donation program of TMC, as well as the nurses and staff who were so caring, friendly and helpful,” says Kim.

For Kim and all transplant patients, life after their life-giving surgery indeed requires quite a number of changes. They have to take immunosuppressant drugs and come for regular checkups for health monitoring. Kim also adheres to a low-fat diet of mostly fruits and vegetables and none of the junk or fatty foods she used to eat before.

“I am also very careful when going out with friends, preferably not in the malls or other crowded places,” says Kim.

Kim has also connected with other liver transplant patients and candidates who have been a great source of support as well as information, according to her and mom Blesilda.

Kim plans to resume her studies next school year as a 4^th year college student at the Philippine Women’s University where she is taking up Bachelor of Secondary Education major in English. She had to stop schooling in June 2016 to prepare for her liver transplant operation.

Aside from taking good care of her health and going back to college, Kim also wants to give back to patients who are suffering from end-stage liver disease. One of the ways she can think of is by helping promote organ donation.

“I wish people would be more open to be an organ donor and that more families would be more willing to donate organs of their deceased loved ones. Please be a donor and talk to everyone you know about it.  You can make a difference,” says Kim.

The Center for Liver Disease Management and Transplantation is a specialty unit of The Medical City that offers a comprehensive array of diagnostic and therapeutic options for patients with liver diseases and liver tumors through an integrated and highly skilled multidisciplinary, patient-partnership approach. It is otherwise known as The Medical City Liver Center and may be reached through 9887000 local 6506.